Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright October 25, 1989
In last week’s column I was discussing the term “whiplash” and what it really meant. I described how it was just a descriptive term, usually indicating that someone was experiencing neck pain resulting from a motor vehicle accident.
There is much better, more scientific and more descriptive terminology which we should use when describing these injuries. Post-traumatic cervical hyperflexion-hyperextension sprain for example would cover most of these injuries nicely. Now you see why we use the term “whiplash”?
What should you do when you are sitting in your car, minding your own business, playing with your radio dials, trying to figure out what your new graphic equalizer does and all of a sudden your car is smacked from the rear by some crazy man who was listening to James Brown singing the prison blues at full volume?
Your head snaps backward from the impact and then recoils forward. You have pain in your neck and shoulders and your head begins to throb. You see spots in front of your eyes, your vision is blurred, your ears start ringing and you can’t swallow without it feeling like you have a noose around your neck. You wait on the side of the road until the police arrive. You tell your story. The James Brown fan tells his. You go to the hospital to be checked out.
Fortunately, most hospital emergency rooms are designed to save people’s lives. They are not well equipped to help people’s sore necks. This means the staff at the hospital will probably send you for some X-rays, ask you to try to bend your neck, give you one of those sympathy grabbing neck braces and send you to your family doctor.
If your neck is broken the doctors and nurses will know what to do to help you. If it isn’t broken they really don’t know what to do next.
The next day you get in to see your doctor. He examines you and declares that you have “whiplash.” If he is in an academic mood he might say that you have a “post-traumatic cervical hyperfelxion-hyperextension strain of the soft tissues of the cervicothoracic spine”. You are then instructed to put ice on your neck and rest. What else should you do?
Most studies indicate that the earlier proper, effective treatment of these “whiplash” injuries is instituted, the faster and more complete will be the recovery.
Exactly what constitutes proper, effective treatment? This depends on each individual case. It might mean complete rest for the patient, although this is only necessary in the most serious cases. It might mean instituting a course of range-of-motion exercises as soon as possible. This might even be the very first day after the accident.
Proper treatment might mean that the patient’s neck joints should be mobilized (loosened up) or it might mean that these joints should be immobilized in a collar. Ultrasound, laser, heat, ice, movement, rest, exercise, mobilization, manipulation, traction, neck supports and massage all have some place in the treatment of an acute whiplash patient.
Exactly what is done, and when, should be determined by the patient’s own doctor or chiropractor. Do not listen to a doctor or chiropractor who sees you once or twice, doesn’t recommend any form of therapy and then tells you to come back in a few months so he can see how you are doing. You might be fine when you see him again, but you might also be one or two months behind schedule in your rehabilitation time.
You might go back to this doctor two months later, he might say that your neck is very stiff and that you should go for therapy. By the time you get an appointment a few more weeks have lapsed. The therapist then tells you that you could have been helped much more effectively if you had come in sooner. Too bad.
Ask questions when you are injured. What else can I do, doc, to make this pain go away quicker? Can I do anything at home to help my situation? Is there anyone else who can speed up my healing better than you?
I remember a case where I was treating a teenager who was injured in a car accident. Her boyfriend was also injured. He went to his doctor. She went to hers. She was referred to my office for treatment. She responded nicely and got better as quickly as could be expected. She kept telling me her boyfriend wanted to go to a chiropractor but his doctor didn’t think it would help him. Despite the fact that he could have gone to any chiropractor without a medical referral, he didn’t want to go against his doctor’s wishes.
He continued to suffer with his pain. He missed several months from work and was not having any therapy at all. His girlfriend was fully recovered within a few months.
I do not want to imply that I could have fixed that person’s neck. I do not want to imply that going to a chiropractor will ensure that you are 100 per cent better within a few months. Maybe I could not have helped him one little bit, or maybe I could have made him feel much better within a few days. I don’t know because I never saw him. I never examined him.
The point here is that this person should have been more aggressive and taken control of his own health. He should have asked his doctor why he was not being referred to someone that might help him more than he was being helped by sitting at home watching Wheel of Fortune.
He was not getting better. He should have asked questions. Most people want to listen to their doctor’s advice, as they should. But it never hurts to ask questions, especially when your own health is on the line.